Bumetanide

Pronunciation: byoo-MET-a-nide.

Generic name
bumetanide
Drug class
Loop diuretic
Form
Tablets (0.5 mg, 1 mg, 2 mg, 5 mg depending on market); oral solution (0.2 mg/mL, UK)
Route
Oral (tablet, oral solution); intravenous/intramuscular injection also exists for hospital use
Legal status
Prescription-only

Availability and supply rules vary by country

Trade names by country: United States · United Kingdom · Canada · Australia · New Zealand

Australia: Burinex (plus generic bumetanide 5 mg tablet) (5) · Full directory

What bumetanide is and how it works

Bumetanide is a prescription-only, potent loop diuretic ('water pill') used to reduce excess fluid (oedema) in the body caused by conditions such as heart failure, liver disease, or kidney disease. It works quickly and is considerably more potent, milligram for milligram, than the more commonly known loop diuretic furosemide. (1)

Because bumetanide works quickly and strongly, your prescriber will monitor your blood tests (especially electrolytes like potassium and sodium, and kidney function) regularly, particularly when starting treatment or changing your dose, to catch dehydration or electrolyte imbalance early.

Mechanism of action: how bumetanide works

Bumetanide is a loop diuretic acting at the ascending limb of the loop of Henle, inhibiting sodium and chloride reabsorption via the Na-K-2Cl cotransporter, and increasing potassium excretion in a dose-related fashion. It is approximately 40 times more potent by weight than furosemide, with a rapid onset (30-60 minutes orally) and short duration of action, and a plasma half-life of roughly 1-1.5 hours. (1)

What bumetanide is used for

Oedema associated with heart failure

Used to reduce fluid build-up (oedema) associated with congestive heart failure. (1) (2)

Oedema associated with liver disease

Used to reduce fluid build-up associated with liver disease, including cirrhosis. (1) (2)

Oedema associated with kidney disease, including nephrotic syndrome

Used to reduce fluid build-up associated with kidney disease, including nephrotic syndrome. (1) (2)

Acute pulmonary oedema (some countries)

In Australia, bumetanide is also indicated for acute pulmonary oedema (fluid in the lungs), typically managed in hospital. (5)

Before taking bumetanide

Do not take / not appropriate for

  • Do not take bumetanide if you are producing no urine (anuria) or very little urine (oliguria), or if your kidney disease is worsening with rapidly rising blood tests (urea/creatinine), until your prescriber has reassessed you. (all countries) (1) (2)
  • Do not take bumetanide if you are in hepatic coma or have severe electrolyte depletion, until this is corrected. (all countries) (1) (2)
  • Do not take bumetanide if you have had an allergic reaction to it, or (in some markets) if you have a known sulfonamide allergy without discussing this first with your prescriber. (all countries) (1) (2)
  • Bumetanide should generally not be combined with lithium. (United Kingdom) (2)

Tell your clinician about

  • Any kidney, liver, or heart problems.
  • Any history of gout or high uric acid levels.
  • Any history of hearing problems, especially if you also have kidney problems or take other medicines that can affect hearing.
  • Any allergy to sulfonamide medicines.
  • All other medicines you take, especially digoxin, lithium, aminoglycoside antibiotics, NSAIDs, or other blood pressure medicines.
  • Pregnancy, plans for pregnancy, or breastfeeding.
(1) (2)

How to take bumetanide

  • Bumetanide is usually taken as a single daily dose, often in the morning, to avoid needing to urinate frequently during the night.
  • Your prescriber may use an intermittent schedule (for example, dosing on alternate days, or a few days on followed by a day or two off) to help maintain control of fluid retention over time.
  • Do not change your dose or stop taking bumetanide without talking to your prescriber, even if you feel well.
  • Your prescriber will monitor your blood tests (electrolytes, kidney function) periodically, especially after starting or changing your dose.
(1) (2) (6)

Procedures and treatment changes

Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6)

Missed dose

If you miss a dose, take it as soon as you remember on the same day, but if it is close to bedtime, contact your prescriber or pharmacist for advice rather than taking it late (to avoid needing to urinate frequently overnight) -- do not double up doses.

Overdose

Seek urgent medical attention if too much bumetanide may have been taken, or if symptoms of severe dehydration, dizziness, or an irregular heartbeat occur, since excessive dosing can cause profound fluid and electrolyte loss. (1)

Side effects

Side effects and their urgency vary; report severe, persistent, or concerning symptoms.

Increased urination (the expected effect of the medicine).

What to notice: Increased urination (the expected effect of the medicine).

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Dizziness or light-headedness, especially on standing up, due to lowered blood pressure.

What to notice: Dizziness or light-headedness, especially on standing up, due to lowered blood pressure.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Muscle cramps.

What to notice: Muscle cramps.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Low potassium or other electrolyte changes on blood tests.

What to notice: Low potassium or other electrolyte changes on blood tests.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1) (2)

Raised uric acid levels.

What to notice: Raised uric acid levels.

What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)

Serious warnings

Signs of excessive fluid and electrolyte loss — high caution

Symptoms: Severe thirst, dry mouth, dizziness, confusion, muscle weakness or cramping, a fast or irregular heartbeat, or reduced urination.

Action: Contact your prescriber promptly or seek urgent care -- bumetanide can cause profound diuresis with water and electrolyte depletion if the dose is too high for you, particularly in older adults; regular blood test monitoring is important. (1)

Signs of hearing problems — high caution

Symptoms: Ringing in the ears (tinnitus), hearing loss, or a feeling of fullness in the ears.

Action: Tell your prescriber promptly -- ototoxicity (hearing damage) has occurred, especially with rapid intravenous administration, in people with kidney impairment, at higher-than-recommended doses, or when combined with other medicines that can affect hearing. (1)

Signs of low potassium, especially if you also take digoxin — high caution

Symptoms: Muscle weakness, cramps, palpitations, or an irregular heartbeat.

Action: Tell your prescriber -- low potassium increases the risk of digoxin toxicity; your prescriber will monitor your blood levels. (1)

Signs of a severe skin reaction — high caution

Symptoms: Widespread skin blistering or peeling, painful rash, or sores in the mouth/eyes.

Action: Seek urgent medical attention -- rare but serious skin reactions (Stevens-Johnson syndrome and toxic epidermal necrolysis) have been reported. (2)

Interactions

  • Aminoglycoside antibiotics (e.g. gentamicin): avoid combining except in life-threatening situations, due to an increased risk of hearing damage and kidney injury. (1)
  • Lithium: generally should not be combined with bumetanide, since diuretics reduce the kidneys' ability to clear lithium, raising the risk of lithium toxicity. (1) (2)
  • Digoxin: bumetanide-induced potassium loss can increase the risk of digoxin toxicity -- monitoring of potassium and digoxin levels is important. (1) (2)
  • Other blood pressure medicines: bumetanide can add to their blood-pressure-lowering effect, sometimes requiring a dose adjustment of the other medicine. (1)
  • NSAIDs (including indomethacin): may reduce bumetanide's diuretic effect. (1) (2)
  • Probenecid: can reduce bumetanide's diuretic (natriuretic) effect -- concurrent use is not generally recommended. (1)
  • Certain other medicines (e.g. some other antibiotics) may increase the risk of toxicity when combined with bumetanide. (2)

Pregnancy, breastfeeding, kidney/liver function, age

Pregnancy

There are no adequate, well-controlled studies of bumetanide in pregnant women. Some regulators (e.g. the UK) advise avoiding use in the first trimester specifically. Discuss the balance of benefits and risks with your prescriber. (1) (2) (3) (4) (5) (6)

Breastfeeding

The US label advises that breastfeeding should not be undertaken while taking bumetanide. The UK label advises discontinuing breastfeeding unless considered essential, with monitoring of the infant for adverse effects if continued. Discuss with your prescriber. (1) (2) (3) (4) (5) (6)

Children

Not generally recommended for children under 12 years in the UK label reviewed; paediatric use elsewhere should be individually directed by a specialist. (1) (2) (3) (4) (5) (6)

Elderly

Older adults may need a lower starting dose (for example, as low as 0.5 mg daily in the UK) and are at higher risk of dehydration, electrolyte imbalance, and circulatory collapse from excessive diuresis -- closer monitoring is important. (1) (2) (3) (4) (5) (6)

Hepatic_impairment

Contraindicated in hepatic coma or states of severe electrolyte depletion until corrected; used cautiously with monitoring in other liver disease, since it is a treatment for oedema caused by liver disease. (1) (2) (3) (4) (5) (6)

Renal_impairment

Contraindicated in anuria; ototoxicity risk is higher in significant renal impairment, especially with higher doses or rapid IV administration -- used with caution and monitoring. (1) (2) (3) (4) (5) (6)

Monitoring

Before starting

  • Baseline kidney function (urea/creatinine)
  • Baseline electrolytes (potassium, sodium)
  • Baseline blood pressure
  • Review of other medicines, especially digoxin, lithium, and aminoglycosides

During treatment

  • Regular serum electrolyte monitoring, especially at treatment initiation and after dose changes.
  • Kidney function monitoring.
  • Blood pressure monitoring, particularly for symptoms of low blood pressure.
  • Uric acid monitoring if gout symptoms develop.
  • Hearing assessment if any auditory symptoms occur, especially in patients with renal impairment or on other ototoxic medicines.
(1) (2)

Storage

Store bumetanide tablets at room temperature (below 25°C), in the original packaging to protect from light and moisture, as directed on the product label.

Study the drug class: Loop diuretics

Professional information

Clinician-facing context only, sourced from the current US FDA/DailyMed prescribing information and UK emc SmPC; verify against the current full label in the relevant jurisdiction before prescribing.

United States

Indication: Oedema (cardiac, hepatic, renal, including nephrotic syndrome)

Dose summary: 0.5-2 mg orally once daily; additional doses at 4-5 hour intervals as needed, up to 10 mg/day maximum; intermittent dosing schedules recommended for maintenance.

Renal context: Contraindicated in anuria; used cautiously with monitoring in renal impairment; ototoxicity risk increased in significant renal impairment. (1)

United Kingdom

Indication: Oedema (cardiac, renal, hepatic)

Dose summary: Adults typically start low and titrate every 12-24 hours; elderly 0.5 mg/day may suffice; not generally recommended under 12 years.

Renal context: Contraindicated in anuria/oliguria; caution and monitoring in renal impairment. (2)

Mechanism of action

Hepatic guidance

Used for oedema due to liver disease but contraindicated in hepatic coma or uncorrected severe electrolyte depletion; monitor closely in hepatic impairment.

Overdose note

Overdose principally causes profound fluid and electrolyte depletion with dehydration and circulatory collapse; management is supportive with fluid/electrolyte replacement and monitoring. (1)

Frequently asked questions

Is bumetanide available in the US, UK, Europe, Canada, Australia, and New Zealand?

Yes, it is approved and available in all of these regions, sold as Bumex (historically, in the US) or Burinex (UK, Canada, Australia, New Zealand, and other countries), as well as generic bumetanide. (1) (2) (3) (4) (5) (6)

Why do I need regular blood tests while taking bumetanide?

Bumetanide is a potent diuretic, and excessive fluid loss can cause dehydration and dangerous drops in electrolytes like potassium and sodium. Regular blood tests let your prescriber catch and correct these changes early, especially when starting treatment or changing your dose. (1) (2)

Is bumetanide stronger than furosemide?

Yes, milligram for milligram -- 1 mg of bumetanide has a diuretic effect roughly equivalent to 40 mg of furosemide. This is clinician-facing context only; never switch between these medicines or adjust your dose based on this ratio without your prescriber's direction. (1) (5)

What is the mechanism of action of bumetanide?

Bumetanide is a loop diuretic acting at the ascending limb of the loop of Henle, inhibiting sodium and chloride reabsorption via the Na-K-2Cl cotransporter, and increasing potassium excretion in a dose-related fashion. It is approximately 40 times more potent by weight than furosemide, with a rapid onset (30-60 minutes orally) and short duration of action, and a plasma half-life of roughly 1-1.5 hours. (1)

What is the generic name of Bumetanide?

The generic name is bumetanide. (1)

What class of drug is bumetanide?

Bumetanide is classed as: Loop diuretic. (1)

References

  1. BUMETANIDE tablet (Bumex) -- prescribing informationU.S. Food and Drug Administration / DailyMed (NIH), prescribing information for bumetanide tablets (Bumex) · United States · accessed 2026-07-30 · source 1
  2. Bumetanide 5 mg Tablets -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom · United Kingdom · accessed 2026-07-30 · source 2
  3. Bumetanide -- Summary of Product Characteristics (Malta Medicines Authority, representative EU national authorisation)EU national medicines regulator example (Malta Medicines Authority SmPC, representative of national-authorisation pattern across EU member states) · European Union · accessed 2026-07-30 · source 3
  4. BURINEX (bumetanide) Product MonographHealth Canada product monograph, Burinex (bumetanide) · Canada · accessed 2026-07-30 · source 4
  5. BURINEX (bumetanide) -- ARTG registrationTherapeutic Goods Administration (TGA), Australia · Australia · accessed 2026-07-30 · source 5
  6. Burinex 1 mg Tablets -- New Zealand Data SheetMedsafe (New Zealand regulator) · New Zealand · accessed 2026-07-30 · source 6

Brand names by country

Single-ingredient bumetanide names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.

Priority countries

United States

  • Bumex2 mg, .5 mg, 1 mg · validus pharmaceuticals llc
  • Enbumyst.5 mg/.1mL · corstasis usa llc

United Kingdom

  • Burinex (plus generic bumetanide tablets/oral solution) (2)MHRA licensed emc smpc confirmed · 1 mg tablet, 5 mg tablet, 0.2 mg/mL oral solution · Viatris (formerly Mylan/Upjohn); LEO Pharma

Canada

  • BURINEX

Australia

  • Burinex (plus generic bumetanide 5 mg tablet) (5)TGA ARTG registered confirmed schedule 4 · 1 mg tablet, 5 mg tablet · LEO Pharma Pty Ltd

New Zealand

  • Burinex (6)Medsafe approved confirmed · 1 mg tablet · Medsafe-approved sponsor
View brands in additional countries.

European Union

Bumetanide (various national brand names) (3)

This page provides general reference information about bumetanide (Bumex/Burinex) and is not a substitute for advice from the prescriber managing your treatment. All dosing and treatment decisions should be made with your prescriber.

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